OBJECTIVE To investigate the correlation of component content with colorimetric values during the roasting process of Ziziphus jujuba ， and to provide criteria for discriminating the roasting degree of Z. jujuba . METHODS Samples were prepared by dry stir-frying for different roasting times. The eight main components in raw Z. jujuba and the samples stir-fried for different roasting times-namely adenosine， magnoflorine， jujuboside A， spinosin， 6-feruloylspinosin， betulinic acid， oleic acid， and linoleic acid-were quantitativel y analyzed using ultra-performance liquid chromatography. The chromaticity values were determined using a UV spectrophotometer. The correlation and differences between the chromaticity values of Z. jujuba at different roasting times and their components content were analyzed by Pearson correlation analysis， linear regression analysis， principal component analysis （PCA） ， cluster heatmap analysis （CHA）， and partial least squares discriminant analysis （PLS-DA） to clarify the processing endpoint. RESULTS As the roasting time increased， the contents of linoleic acid and oleic acid decreased， while the contents of other components exhibited an increasing trend. Concurrently， the colorimetric value L* and E*ab were observed to decline， whereas the a* value demonstrated a gradual increase. Pearson correlation analysis revealed that L* and E*ab exhibited a significant negative correlation with the contents of adenosine， spinosin， 6-feruloylspinosin， jujuboside A， betulinic acid and magnoflorine （ P ＜0.05）. The results of linear regression analysis indicate that the content of six components, including adenosine， in the medicinal material can be preliminarily predicted by analyzing the colorimetric values of Z. jujuba powder. PCA and CHA successfully classified raw and stir-fried samples. The PLS-DA results indicated that L*， E*ab， a*， linoleic acid content， and oleic acid content were the main parameters that differentiated the color and quality of Z. jujuba at different roasting times. After frying for 9 to 10 minutes， the colorimetric values L* and E*ab decreased to their minimum values and stabilized， while a* remained consistently high with little variation；simultaneously， the concentrations of the six major components， excluding linoleic acid and oleic acid， reached their peak levels. CONCLUSIONS A significant correlation between the colorimetric values of Z. jujuba and the contents of six components， including adenosine， is confirmed. The optimal roasting time range is determined to be 9-10 minutes. Furthermore， the colorimetric value-component content correlation analysis method established in this study proved to be practical and applicable for discriminating the roasting degree of Z. jujuba .

ObjectiveTo investigate the independent predictive factors for 90-day mortality in patients with acute-on-chronic liver failure （ACLF）， to establish a risk predictive model， and to assess its predictive efficacy in comparison with MELD， MELD-Na， MELD 3.0， and COSSH-ACLF Ⅱ. MethodsA retrospective analysis was performed for the clinical data of 394 patients with ACLF who were admitted to The Affiliated Hospital of Inner Mongolia Medical University and Hohhot Second Hospital from July 2018 to July 2024， and general information and laboratory markers on admission were collected from all patients. The independent-samples t test or the Mann-Whitney U test was used for comparison of quantitative data between two groups， and the chi-square test or the adjusted chi-square test was used for comparison of qualitative data between two groups. The LASSO regression analysis was used to identify related variables， and the multivariate logistic regression analysis was used to establish a predictive model and generate a nomogram. The receiver operating characteristic （ROC） curve， the area under the ROC curve （AUC）， calibration curve， and clinical decision curve were used to assess the performance of the model. ResultsA total of 394 patients with ACLF were included in this study， with 136 patients in the training set， 58 in the internal validation set， and 200 in the external validation set. The cohort had a mean age of 52.9±11.7 years， among whom male patients accounted for 72.84% （287/394）， the patients with HBV infection accounted for 22.33% （88/394）， the patients with alcohol-related causes accounted for 45.94% （181/394）， and the patients with other causes （including drug-induced and autoimmune diseases） accounted for 31.73% （125/394）. The overall 90-day mortality rate was 27.41% （108/394）. The multivariate logistic regression analysis showed that diabetes （odds ratio ［OR］= 5.831， 95% confidence interval ［CI］： 1.587 — 21.424， P=0.008）， cystatin C （Cys-C） （OR=2.984， 95%CI： 1.501 — 5.933， P=0.002）， and spontaneous peritonitis （SBP） （OR=5.692， 95%CI： 2.150 — 15.071， P<0.001） were independent risk factors， and a nomogram was generated based on these factors. This model had an AUC of 0.836 in the training set， 0.881 in the internal validation set， and 0.878 in the external validation set， showing a good discriminatory ability. The calibration curve showed a good degree of fitting， with a relatively high net clinical benefit. The subgroup analysis based on etiology showed that the model had an AUC of 0.850 in the patients with HBV infection， 0.858 in the patients with alcohol-induced ACLF， and 0.908 in the patients with other etiologies， indicating that the model had a good discriminatory ability across the populations with different etiologies. Compared with traditional scores， the model （AUC=0.836） had a significantly better predictive value than MELD （AUC=0.619， Z=3.197， P=0.001）， MELD-Na （AUC=0.651， Z=2.998， P=0.003）， MELD 3.0 （AUC=0.601， Z=3.682， P<0.001）， and COSSH-ACLF Ⅱ （AUC=0.719， Z=2.396， P=0.017） alone. ConclusionDiabetes， SBP， and Cys-C are independent risk factors for 90-day mortality in patients with ACLF. Compared with MELD， MELD-Na， MELD 3.0， and COSSH-ACLF Ⅱ scores， this model has a higher predictive value for 90-day prognosis in patients with ACLF and is suitable for patients with ACLF caused by various etiologies.

AIM:To investigate the visual development of children under 6 years old in Wuhan, and provide evidence-based support for the formulation and optimization of regional policies for children's eye health care.METHODS:Suresight refractive screener was applied to rapid refractive status examination in 4 989 preschool children under 6 years old in Wuhan City, with results determined according to the manufacturer's age-specific referral criteria. All screened pre-school children completed vision screening and comprehensive ophthalmic examination.RESULTS: A total of 4 989 children under 6 years old were screened out, including 2 641 males and 2 348 females. They were divided into 6 groups according to age: 426 aged from 6-month to 1-year-old, 903 aged >1 to 2 years old, 1 078 aged >2 to 3 years old, 442 aged >3 to 4 years old, 808 aged >4 to 5 years old, and 1 332 aged >5 to 6 years old. The abnormal rate in the 6-month to 1-year-old group was 44.60%, in the >1 to 2 years old group was 26.02%, in the >2 to 3 years old group was 15.58%, in the >3 to 4 years old group was 10.86%, in the >4 to 5 years old group was 21.91%, in the >5 to 6 years old group was 23.27%, and the total refractive abnormal rate for children aged 6 mo to 6 years old was 22.61%. The refractive abnormal rate generally showed a decreasing trend with increasing age(P<0.001); the refractive abnormal rate in boys aged 6-month to 6 years old was 12.33%, and in girls was 10.28%, with no statistically significant difference in the abnormal rate between boys and girls(P>0.05); among children aged 6-month to 6 years old, the abnormal rate of single-eye myopia was 0.98%, of single-eye hyperopia was 5.41%, of single-eye astigmatism was 9.92%, of binocular myopia was 0.98%, of binocular hyperopia was 2.79%, and of binocular astigmatism was 8.14%; the prevalence of astigmatism in children aged 6-month to 1-year-old was 40.38%, in those aged >1 to 2 years old was 19.82%, in those aged >2 to 3 years old was 12.34%, in those aged >3 to 4 years old was 9.05%, in those aged >4 to 5 years old was 18.81%, and in those aged >5 to 6 years old was 16.89%; the prevalence of astigmatism in children aged 6-month to 6 years old was 18.06%. The abnormal rate of astigmatism in the four age groups ranging from 6-month to 4 years old decreased continuously with age(P<0.001). There was no statistically significant difference in the abnormal rate of astigmatism between the >4 to 5 years old group and the >5 to 6 years old group(P>0.05).CONCLUSION:Refractive error has become a common eye disease among preschool children. Through early vision screening, establishing a systematic refractive management file, and early intervention, the best treatment period can be seized to avoid missing it and causing adverse consequences.

Promoting the international acceptance of clinical studies about traditional Chinese medicine (TCM) interventions is a key strategy for internationalization of TCM. However, the complexities of TCM interventions—in terms of the theories, practice patterns, and components—pose challenges to the design and implementation of clinical studies that are well accepted by the international community. This article summarized the current status of clinical studies about TCM interventions that were published in international journals, explored underlying barriers hindering the international acceptance, and discussed potential strategies for future development.

Promoting the international acceptance of clinical studies about traditional Chinese medicine (TCM) interventions is a key strategy for internationalization of TCM. However, the complexities of TCM interventions—in terms of the theories, practice patterns, and components—pose challenges to the design and implementation of clinical studies that are well accepted by the international community. This article summarized the current status of clinical studies about TCM interventions that were published in international journals, explored underlying barriers hindering the international acceptance, and discussed potential strategies for future development.

Promoting the international acceptance of clinical studies about traditional Chinese medicine (TCM) interventions is a key strategy for internationalization of TCM. However, the complexities of TCM interventions—in terms of the theories, practice patterns, and components—pose challenges to the design and implementation of clinical studies that are well accepted by the international community. This article summarized the current status of clinical studies about TCM interventions that were published in international journals, explored underlying barriers hindering the international acceptance, and discussed potential strategies for future development.

Objective To investigate the effects of periodontitis induced by Prevotella nigrescens(Pn)combined with ligation on cognitive functions in mice.Methods Twenty-four C57BL/6J mice were randomly divided into control group,ligation group,and ligation+Pn treatment(P+Pn)group.Experimental periodontitis was induced by silk ligation of the first molars followed by topical application of Pn for 6 weeks.After modeling,alveolar bone resorption was assessed using micro-CT and histological analysis.Learning and memory abilities of the mice were evaluated using open field test(OFT),novel object recognition test(NORT),and Morris water maze test(MWM).Seven weeks after the start of modeling,the mice were sacrificed for examining histopathological changes in the hippocampus using HE and Nissl staining.Results After 6 weeks of molar ligation,micro-CT revealed horizontal alveolar bone resorption and furcation exposure in the mice,and histological analysis showed apical migration of the junctional epithelium,epithelial ridge hyperplasia,and lymphocyte infiltration,and these changes were obviously worsened in P+Pn group.Alveolar bone height decreased significantly in both ligation groups compared to the control group.Cognitive tests showed that the mice in both of the ligation groups traveled shorter distances in OFT,showed reduced novel object preference in NORT,and exhibited longer escape latencies in MWM,and the mice in P+Pn group had significantly poorer performances in the tests.Histologically,obvious neuronal cytoplasmic degeneration,necrosis,nuclear pyknosis,vacuolation,and reduced Nissl bodies and viable neurons were observed in the hippocampal regions of the mice in the two ligation groups.Conclusion Pn infection aggravates alveolar bone destruction,accelerates necrosis and causes morphological abnormalities of neuronal cells in the hippocampus to reduce cognitive functions of mice with periodontitis.

Objective:To investigate the value of coronary CTA (CCTA)-based traditional features and radiomics of plaque in the identification of culprit lesions that caused acute myocardial infarction (AMI).Methods:This was a retrospective multicenter study. From July 2016 to November 2023, a total of 344 patients from the Affiliated Hospital of Qingdao University (training cohort, n=184), Shandong Provincial Hospital Affiliated to Shandong First Medical University (validation cohort, n=88) and Qilu Hospital of Shandong University (test cohort, n=72) who received percutaneous coronary intervention (PCI) due to AMI and underwent CCTA within 48 hours of AMI were enrolled. The culprit plaques and non-culprit plaques were identified using a combination of electrocardiogram, CCTA, and angiographic findings. The vessel, plaque location, plaque type, Coronary Artery Disease-Reporting and Data System (CAD-RADS) score, high-risk plaque characteristics, plaque length, plaque volume, and burden were analyzed, and 1 904 radiomics features were extracted for each plaque. The traditional imaging model, the radiomics model, and the combined model were established by using multivariate Logistic regression analysis. The area under the receiver operating characteristic curve (AUC) was used to evaluate the performance of each model in identifying culprit lesions. The DeLong test was used for the comparison of AUC between every two models. The net reclassification index (NRI) was used to evaluate the incremental value of the combined model to the traditional imaging model and the radiomics model. The decision curve analysis (DCA) was used to assess the clinical net benefit of these models. A correlation heatmap was used to evaluate the correlation between the radiomics score and traditional CCTA factors. The interpretable analysis of the decision process of the combined model was performed by the Shapley Additive exPlanations (SHAP). Results:In the validation cohort and the test cohort, the AUC of the traditional imaging model developed by the vessel, plaque type, positive remodeling and CAD-RADS score was 0.898 (95% CI 0.869-0.922) and 0.881 (95% CI 0.848-0.910), respectively. The radiomics model developed by six radiomics features was 0.863 (95% CI 0.831-0.891) and 0.863 (95% CI 0.827-0.864), respectively. The AUC of the combined model was 0.930 (95% CI 0.905-0.950)and 0.919 (95% CI 0.889-0.942), respectively. In the validation cohort and the test cohort, the AUC of the combined model was higher than that of the traditional imaging model ( Z=4.013, 4.272, P<0.001) and that of the radiomics model ( Z=4.819, 3.784, P<0.001), respectively. In the validation cohort, the combined model yielded an NRI of 20.43% (95% CI 10.43%-30.44%, P<0.001) and 20.21% (95% CI 9.62%-30.80%, P<0.001) for identifying culprit lesions compared with the traditional imaging model and the radiomics model, respectively. In the test cohort, the combined model yielded an NRI of 28.05% (95% CI 16.72%-39.38%, P<0.001) and 23.57% (95% CI 13.58%-33.56%, P<0.001) for identifying culprit lesions compared with the traditional imaging model and the radiomics model, respectively. DCA showed the combined model had the highest clinical net benefit. The correlation heatmap showed the radiomics score was not correlated or only weakly correlated with traditional CCTA factors. SHAP indicated the radiomics and CAD-RADS score contributed significantly to the model. Conclusion:The CCTA-based traditional features and radiomics of plaque have favorable performance for the identification of culprit plaques in patients with AMI.

Objective:To analyze the current status of the standard system construction for smart health and elderly care in China,analyze the framework of the standard system,and propose policy recommendations for the construction of the standard system.Methods:The standard system of smart health and elderly care were searched on the websites of the State Council of China,the National Standard Information Public Service Platform,and the sub-websites of national,industry,local,group,and enterprise standards.Policy text analysis was used to explore the current status and framework of standard system construction.Results:Currently,67 standards related to smart health and elderly care in China were included,including 0 national standards,2 industry standard,10 local standards,31 group standards,and 24 enterprise standards.These standards formed a subsystem that covered general,data,product,platform,and service standards.Conclusion:The construction of the standard system of smart health and elderly care in China has achieved certain results,but there are still shortcomings,and it is necessary to strengthen the top-level design and build a perfect framework of the standard system.

Objective:To explore impacts of nuciferine(Nuci)on liver fibrosis and inflammatory reaction in cirrhotic rats through p38MAPK-PPARγ/NF-κB signal pathway.Methods:Six SD rats were randomly selected as control(NC)group,other rats were injected with thioacetamide(TAA)into peritoneum at a dose of 200 mg/kg to induce cirrhosis.Rats successfully modeled were randomly grouped into Model group,Nuci group(20 mg/kg Nuci),anisomycin group(5 mg/kg Nuci p38MAPK-PPARγ/NF-κB signal pathway activator anisomycin),and Nuci+anisomycin group(20 mg/kg Nuci+5 mg/kg anisomycin),with 6 rats in each group.The NC group and the Model group were given the same amount of normal saline once a day for 8 weeks.Serum inflammatory index and liver function index were detected by ELISA kits;HE staining was applied to detect pathological changes of liver;Masson staining was applied to detect liver fibrosis;Western blot was applied to detect pathway related proteins levels.Results:In NC group,cell structure was normal,only a small amount of collagen was deposited,no collagen fiber proliferation was observed,and liver lobule was clearly stained.Compared with NC group,hepatocytes in Model group were enlarged,accompanied by inflammatory cell infiltration,and in-creased collagen fiber proliferation,IL-1β,TNF-α,alanine aminotransferase(ALT),IL-6,hyaluronic acid(HA),aspartate amino-transferase(AST),type Ⅲ procollagen(PCⅢ),total bilirubin(TBIL)content,laminin(LN),collagen volume fraction,p-p38MAPK/p38MAPK,p-NF-κB p65/NF-κB p65 proteins levels were significantly increased(P<0.05),PPARγ protein level was significantly decreased(P<0.05).Nuci treatment improved inflammatory cell infiltration and necrosis in liver tissue,levels of IL-1β,IL-6,TNF-α,ALT,AST,TBIL,HA,LN,PCⅢ,collagen volume fraction,p-p38MAPK/p38MAPK,p-NF-κB p65/NF-κB p65 pro-teins were significantly decreased(P<0.05),PPARγ protein level was significantly increased(P<0.05),trend of anisomycin group was opposite to that of Nuci group;anisomycin eliminated therapeutic effect of Nuci on cirrhotic rats.Conclusion:Nuci may reduce liver fibrosis and inflammation in cirrhotic rats by down-regulating p38MAPK-PPARγ/NF-κB signal pathway.